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inKL E I N F E L D E R <br /> PROJECT NO. PROJECT NAME RECEIVING lA9: <br /> 5 Z'� �. & O I 4_i. I ✓L eI 6.tel NL. NO. TYPE <br /> LP.NO. SAMPLE :(Signature r) <br /> (P.O.NO. `/ [ OF OF h <br /> r �O 05 � INSTRUCTIONS/REMARKS <br /> CON- CON- <br /> DATE SAMPLE I. TAINERS TAINERS �1 <br /> TIME SAMPLEI.D. MATRIX <br /> MWDDM HH-MM-SS `J <br /> 1v �1n1 ('0'Y S +P� O T✓�. <br /> 2 I0 :30: iI"D z z 8 . Q 3 Lg35 / -t( � Far " 0 rL-0I with <br /> 4 Z(a u <br /> 5 <br /> e <br /> 7 <br /> e <br /> g <br /> To <br /> 11 <br /> 12 <br /> 19 <br /> 1< <br /> 15 <br /> 16 <br /> i] <br /> 18 <br /> 19 <br /> [b <br /> Relinqui by:(Sign Date rime eceived b:(Signal Instructions/Remarks: Send Results To: <br /> S 0� 1v1) 0 <br /> Reli ui h y: S nature) Dow Time ac ed by:(Si a red D KLEINFELDER <br /> CJI 2825 EAST MYRTLE STREET <br /> r STOCKTON, CA 95205 <br /> (209)948-1345 <br /> inquisbe y:ISignatme) Date/time Received for laboratory by:(Signature) <br /> AIN: <br /> (Z5,4 [-0 10ttf5�� <br /> M 60 White-Sampler Canary-Return Copy To Shipper Pink-Lab Copy <br /> CHAIN OF CUSTODY N2 2615 <br />